Application for Employment | All Star Striping

All Star Striping is an Equal Opportunity Employer

Last Name:*

First Name:*

Middle Initial*

Physical Address*

Street Address City State / Province / Region ZIP / Postal Code

Mailing Address (if different)

Street Address City State / Province / Region ZIP / Postal Code

Day Phone*

Evening Phone*

Valid Driver's License*

Yes

Class of License*

Endorsements*

List any safe driving awards you have received*

General Information

Position you are applying for*

Hourly rate desired*

Date available to start work*

Are you willing to submit to drug testing?*

Yes

Convicted of a felony in the last 7 years?*

Yes

Are you willing to work overtime?*

Yes

Do you have special skills, training or experience which may be valuable to this job?*

Yes

If so, please explain*

Do you have a reliable means of transportation to get to work?*

Yes

Are there any times during the week that you are unavailable to work?*

Yes

If so, please explain*

Have you applied for employment here before?*

Yes

How did you hear about the job you are applying for?*

References

List Three People not Related to You. Please Provide at "Least" one Professional Reference

Name*

Phone*

Choose one*

Professional

Personal

Name*

Phone*

Choose one*

Professional

Personal

Name*

Phone*

Choose one*

Professional

Personal

Education

Are you a High School Graduate?*

Yes

If no, please indicate the highest grade completed*

College, Business or Trade Schools (Name and Location)*

Major or Vocational Subjects*

Degree/Certificate Completed*

Work Experience

List Most Recent Employer First

Employer 1

Dates Employed*

Company Name*

Job Title*

Address*

Phone*

Reason for Leaving*

Starting Pay*

Ending Pay*

Additional Skills / Equipment Knowledge*

Employer 2

Dates Employed*

Company Name*

Job Title*

Address*

Phone*

Reason for Leaving*

Starting Pay*

Ending Pay*

Additional Skills / Equipment Knowledge*

FMCSR's

Were you subject to FMCSR's while with any of your previous Employers?*

Yes

Were you subject to the drug and alcohol testing requirements of 49 CFR Part 40?*

Yes

If yes, please list (Company Names AND Phone Numbers)*

Driving Experience

Please indicate if you have one or more years of experience operating equipment listed below

Straight Truck*

Yes

Dates Operated*

Tractor and Semi-trailer*

Yes

Dates Operated*

Other: please specify*

Yes

Please specify*

Dates Operated*

Please list all states you have operated in within the last five years:*

Moving Violation Record

Please list for the last three years: All Accidents, Convictions and Forfeitures

Date of Violation*

Nature of Violation*

Accidents, Convictions and Forfeitures

Date of Violation*

Nature of Violation*

Accidents, Convictions and Forfeitures

Date of Violation*

Nature of Violation*

Accidents, Convictions and Forfeitures

Driving Privilege

Have you ever been denied a license, permit or privilege to operate a motor vehicle?*

Yes

If yes, please explain*

Has any license, permit or privilege been suspended or revoked?*

Yes

If yes, please explain*

Certification and Acknowledgement

I certify that the information provided herein is true and correct to the best of my knowledge; I understand that, if employed, falsified statements on this Application for Employment form will be considered grounds for termination. I authorize All Star Striping, to thoroughly investigate my work experience and any other matters related to my suitability for employment. I further authorize my former employers to disclose to All Star Striping, any and all information they may have concerning my previous employment. In addition I hereby release All Star Striping, my former employers, and all other persons from any and all claims, demands, or liabilities arising out of, or in any way related to, such disclosure. I agree to furnish such additional information and complete such examinations as may be required to complete my application file. I agree that this application process in no way obligates All Star Striping, to employ or hire the applicant, but if found qualified and hired, may be on a probationary period during which time I may be disqualified without recourse. I acknowledge that, if employed, both All Star Striping, and I have the right to terminate the employment relationship at any time, with or without cause or advance notice. This employment is an at will relationship will remain in effect throughout my employment with All Star Striping, and may or may not be modified by any oral or implied agreement.

Applicant's Signature*

Dated*

Attach Résumé*

Max. file size: 32 MB.

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